Direct Project Glossary

Terms below are defined in the Direct Project Overview.

Term	Direct Project Definition
Abstract Model	The basis of the Direct Project's technical specifications, the abstract model provides a common framework for stakeholders to investigate Direct standards and services
ARRA	American Recovery and Reinvestment Act of 2009, also known as the “economic stimulus package.” It includes a bill called HITECH, which provides incentives to providers and hospitals to adopt Health Information Technology.
Authenticate	To verify an identity prior to granting access or asserting trust
CCD	Continuity of Care Document, an XML-based standard that specifies the encoding, structure, and semantics for a document that summarizes a single patient’s clinical information
CCR	Continuity of Care Record, an XML-based standard that specifies a way to create a clinical summary of a patient’s information
Certificate Authority	Issues digital certificates in a public key infrastructure environment
CMS	Centers for Medicaid and Medicare Services
Content	The health information being communicated, which is independent of the technical mechanism used to move it
Direct Address	Used to identify an endpoint (a Sender or Receiver) when information is exchanged. The Direct Address has two parts, a Health End Point Name and a Health Domain Name, for example, drbob@samplehispname.org.
Direct Message	The content of the information being transferred from the Sender to the Receiver. The Direct Message is similar to a package that is sent from one person to another via the postal service, such as the content within an envelope or a box
DNS	Domain Name System, an Internet system to translate human-readable names into Internet addresses
DURSA	Data Use and Reciprocal Support Agreement, a comprehensive agreement that governs the exchange of health data between participants in the Nationwide Health Information Network Exchange
EHR	Electronic Health Record, a computerized system for recording, storing, producing, and using electronic patient medical and health information
Health Domain Name	The delivery location for messages to an individual Direct HISP, the HISP portion of a Direct Project Address
Health End Point	The delivery location for messages to an individual Direct user, the user portion of a Direct Project Address
HIO	Health Information Organization, an organization that holds patient information and/or provides services to allow members of the organization to exchange health information
HISP	Health Information Service Provider, the entity that is responsible for delivering health information as messages between senders and receivers over the Internet.
HITECH	Health Information Technology for Economic and Clinical Health Act, a bill that, as a part of the American Recovery and Reinvestment Act of 2009, aims to advance the use of health information technology such as electronic health records
HITPC	Healthcare IT Policy Committee, a federal advisory committee charged with making recommendations to the National Coordinator for Health IT surrounding standards, implementation specifications, and certifications criteria in order to shape a nationwide infrastructure for the adoption of healthcare information technology and the exchange of meaningful patient medical information
HITSC	Healthcare IT Standards Committee, a federal advisory committee charged with providing standards guidance and testing infrastructure to support the recommendations of the HIT Policy Committee
HL7	Health Level 7, an international standards organization that develops and publishes voluntary consensus technical standards
IDN	Integrated Delivery Network, a network of healthcare organizations organized under a parent holding company that provides a continuum of healthcare service
IHE	Integrating the Healthcare Enterprise, a group of healthcare industry stakeholders that promotes and defines coordination of established standards to provide meaningful and effective information exchange
Meaningful Use	Often abbreviated as MU, defined in the Final Rule from CMS published in July, 2010 under the ARRA HITECH provisions
MIME	Multipurpose Internet Mail Extensions, an Internet standard that extends e-mail to support content beyond simple ASCII plaintext data
Nationwide Health Information Network	A set of standards, services and policies that enable secure health information exchange over the Internet
Nationwide Health Information Network CONNECT	Open source software that embodies the standards and services to support Nationwide Health Information Network specifications
Nationwide Health Information Network Exchange	A diverse set of federal agencies and non-federal organizations that have come together to securely exchange electronic health information using the Nationwide Health Information Network specifications
Nationwide Health Information Network** Specifications	Specifications of the core Nationwide Health Information Network services and standards enabling such functions as locating patients at other participating healthcare organizations. These specifications must be used by Nationwide Health Information Network Exchange participants and may be used by others
Nationwide Health Information Network Workgroup	Part of the federal Health IT Policy Committee
ONC	Office of the National Coordinator for Health Information Technology in the Department of Health and Human Services, the principal Federal entity charged with coordinating nationwide efforts to promote the use of health information technology
PHR	Personal Health Record, an electronic health record managed by a patient. A PHR may be “connected”, opening a patient-friendly portal to information ultimately owned by a healthcare organization, care provider, or insurance company; or it may be “unconnected,” providing a patient-owned space for storing and editing personal medication information
Receiver	Actor in the Direct workflow who receives the message content. A Receiver may be a person or a larger business entity.
Reference Implementation	Open-source software that implements the Direct Project specifications. There may be multiple reference implementations using different technologies (e.g., .NET, Java), and a reference implementation is not normative as the specifications are.
Sender	Actor in the Direct workflow who originates the message content. A Sender may be a person or a larger business entity.
S/MIME	Secure/Multipurpose Internet Mail Extensions, a Internet standard for securing MIME data. S/MIME provides privacy and data security through encryption; and authentication, integrity assurance, and non-repudiation of origin through signing.
SMTP	Simple Mail Transport Protocol, an industry standard for transporting e-mail
XDM	The IHE Cross-Enterprise Document Media Interchange integration profile, a specificationor the exchange of electronic health record documents on portable media. XDM provides an option for zipped file transfer over e-mail, which is very relevant to the Direct Project specifications.
XDR	The IHE Cross-Enterprise Document Reliable Intercharge integration profile, a specification for the interchange of electronic health record documents through reliable point-to-point netowrk communication, based on a a push of information
XDS	The IHE Cross-Enterprise Documenting Sharing integration profile, a specification for managing the sharing, finding, and retrieval of electronic health record documents among a defined group of healthcare enterprises
X.509 Digital Certificates	A standard for asserting that an entity is who it purports to be. The standard is strictly hierarchical, where a trusted entity asserts the identities of a set of child entities, which can make further assertions, ad infinitum.